广泛期小细胞肺癌预后因素分析

Analysis of prognostic factors of extensive disease-small cell lung cancer

目的探讨影响广泛期小细胞肺癌生存的预后因素。方法回顾性分析2011年1月—2019年1月在中日友好医院及中国中医科学院望京医院住院治疗的广泛期小细胞肺癌157例患者的临床资料。单因素分析采用Log-Rank检验分析,生存率曲线组间比较采用Kaplan-Meier法,对单因素分析提示差异有统计学意义的变量行多因素COX比例风险回归模型分析。结果患者性别、确诊时是否存在阻塞性肺炎、肝转移、是否行胸部放疗、一线化疗周期数、二线化疗周期数等6个因素是广泛期小细胞肺癌预后的独立影响因素(P<0.05)。其中,女性、一线化疗≥1周期、二线化疗周期数为4~6周期、行胸部放疗是广泛期小细胞肺癌预后的保护性因素(P<0.05),确诊时存在阻塞性肺炎、肝转移是广泛期小细胞肺癌患者预后的危险因素(P<0.05)。结论女性性别、一线化疗周期数≥1周期、二线化疗周期数为4~6周期、行胸部放疗的广泛期小细胞肺癌患者预后更佳,确诊时已发生阻塞性肺炎及肝转移的广泛期小细胞肺癌患者预后较差。

Objective To investigate the prognostic factors of extensive disease-small cell lung cancer.Methods The clinical data of 157 patients with extensive disease-small cell lung cancer who were hospitalized in China-Japan Friendship Hospital and Wangjing Hospital of Chinese Academy of Chinese Medical Sciences from January 2011 to January 2019 were analyzed retrospectively.Log-Rank test was used for univariate analysis,Kaplan-Meier method was used for comparison of survival curve between groups,and multivariate COX proportional hazard regression model was used for multivariate analysis of variables with statistically significant difference indicated by univariate analysis.Results Six factors,including patient gender,whether have presence of obstructive pneumonia at the time of diagnosis,liver metastasis,whether have thoracic radiation therapy,number of cycles of first-line chemotherapy,and number of cycles of second-line chemotherapy,were independent influencing factors for prognosis of extensive disease-small cell lung cancer(P<0.05).Among them,female,the first-line chemotherapy≥one cycle,number of the second-line chemotherapy cycles four to six cycles,and have thoracic radiation therapy were protective factors for the prognosis of extensive disease-small cell lung cancer patients(P<0.05),and presence of obstructive pneumonia at the time of diagnosis and liver metastasis were risk factors for the prognosis of extensive disease-small cell lung cancer patients(P<0.05).Conclusion Extensive disease-small cell lung cancer patients with female gender,the first-line chemotherapy cycles≥one cycle,and the second-line chemotherapy cycles four to six cycles,have thoracic radiation therapy,have better prognosis,while extensive disease-small cell lung cancer patients with obstructive pneumonia and liver metastasis at the time of diagnosis have worse prognosis.